Delirium Tremens: Symptoms, Causes, and Life-Saving Treatments

Delirium Tremens or DTS is a condition commonly seen in alcohol withdrawal. It is a life-threatening condition, characterized by delirium (as the name suggests) and a wide range of other symptoms. Therefore, it requires immediate medical attention.

DTs, while dangerous, is not a very common condition. As per the “2023 National Survey on Drug Use and Health (NSDUH),” nearly 28.9 million Americans suffer from alcohol use disorder. Out of these 29.9 million, nearly 1% develop DTS.

What Are Delirium Tremens (DTS)?

DTs meaning stands for delirium tremens. It is one of the most severe symptoms of alcohol withdrawal. Alcohol withdrawal usually happens when alcohol intake is reduced or stopped entirely. It is seen among those with alcohol use disorder or those who engage in heavy, uncontrolled drinking. Alcohol withdrawal refers to a series of unpleasant symptoms and takes place in stages. The final stage of alcohol withdrawal, which takes place between 48 hours to 72 hours after the last drink is when a person experiences DTs.

DTS is characterized by delirium, anxiety, agitation, cognitive changes, and hallucinations. It is also linked with heart attack and coma. Therefore, immediate medical attention is required.

If anybody is experiencing delirium tremens, then it is important to contact the doctor/healthcare providers immediately. Even emergency services (like 9-1-1 in the U.S.) can be contacted immediately.

What Are The Symptoms Of Delirium Tremens (DTS)?

Delirium tremens has wide-ranging symptoms, which are as follows:

• Severe confusion (delirium)

• Anxiety

• Agitation

• Hallucinations

• Headaches

• Heavy sweating

• Tremors

• Vomiting

• Seizures

• Hyperthermia or high body temperature

• Tachycardia or rapid heart rate

DTS must not be taken lightly. It is a life-threatening condition, linked with heart attack and coma as well. It leads to fatality if immediate medical attention is not provided. If anyone is suffering from these symptoms, call healthcare providers or emergency services immediately.

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What Are The Causes Of Delirium Tremens (DTS)?

The main cause of delirium tremens is alcohol withdrawal. It is one of the severe symptoms of alcohol withdrawal. Alcohol withdrawal happens when someone with moderate to severe alcohol withdrawal reduces drinking or stops drinking entirely. When the body, especially the central nervous system (CNS), gets used to a certain level of alcohol, it works hard to keep the body awake and in a functioning state, as alcohol is a depressant. Now, when this alcohol level is reduced or completely stopped, the CNS cannot regulate immediately and there is overactivity, leading to alcohol withdrawal.

DTs is not the immediate symptom of alcohol withdrawal. It usually happens between 48 hours to 72 hours after the last drink. Therefore, any symptoms of alcohol withdrawal must be addressed immediately.

Moreover, alcohol intake in cases of moderate to severe alcohol use disorder must only be done under medically supervised conditions. The first stage of which alcohol detox, wherein alcohol is reduced gradually so as to minimize and manage alcohol withdrawal symptoms.

If considering quitting alcohol, seeking medical advice and professional help, therefore, becomes necessary.

Risk Factors For Delirium Tremens (DTS)

There are several risk factors for delirium tremens:

• Heavy alcohol use

• Past instances of quitting alcohol suddenly and entirely

• Previous history of alcohol withdrawal symptoms, including the most severe ones like seizures and DTS

• Pre-existing medical conditions like liver and heart diseases

• Older age

Co-occurring conditions, like other substance use disorders

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How Is DTS Diagnosed?

Delirium tremens is treated as an emergency in the emergency room of any hospital. Diagnosis tests include physical examinations, medical history, lab tests, and even standardized checklists like the Clinical Institute for Withdrawal Assessment for Alcohol Revised Scale.

Other tests for DTs include blood tests, urine tests, EEG, MRI scans, and electrolyte level tests, among others.

What Are The Treatment Options For Delirium Tremens (DTS)?

Delirium tremens is treated as an emergency. Delirium tremens treatments begin with sedatives (mostly benzodiazepines), as these relax the CNS. In certain extreme cases, general anesthesia is used to completely sedate the person.

Other medication involves antipsychotic medication to treat psychotic symptoms like hallucinations, anticonvulsants, pain medication, BP medication, and also heart-related medications. Moreover, as dehydration and nutritional deficiencies are common in cases of DTS, necessary vitamins, minerals, and electrolytes are also provided.

However, the main reason for delirium tremens is alcohol withdrawal, which itself results from alcohol use disorder. So, unless alcohol use disorder is not addressed, DTS cannot be completely treated.

The first step of treating alcohol use disorder is medically supervised detox, where alcohol is gradually reduced so as to minimize and manage alcohol withdrawal symptoms.

Psychotherapy and 12-step recovery programs are also important. These involve motivational interviewing, cognitive behavioral therapy, mindfulness therapy, group therapy, and enrolling in informal peer support groups like Alcoholics Anonymous.

How To Prevent Delirium Tremens (DTS)?

As alcohol withdrawal is the main reason for delirium tremens, the best way to prevent it is to avoid heavy and uncontrolled alcohol intake. Now, what can be considered as heavy drinking differs for males and females:

• Heavy drinking for males is 5 or more drinks per day and 15 or more drinks per week.

• Heavy drinking for females is 4 or more drinks per day and 8 or more drinks per week.

In the case of moderate or severe alcohol use disorder, then reducing or stopping alcohol intake completely is not something that must be attempted on one’s own. It must only be done under medically supervised conditions, therefore, seeking medical advice and professional help becomes necessary.

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Frequently Asked Questions

What is the full form of DTS?

DTS stands for delirium tremens.

What are the first signs of Delirium Tremens?

The first signs of delirium tremens are irritability, tremors, cognitive changes, hallucinations, and severe confusion or delirium.

Can delirium tremens be prevented?

Yes, delirium tremens can be prevented by avoiding heavy drinking. Or, in cases of moderate to severe alcohol use disorder, alcohol intake must only be reduced or stopped under medical supervision.

Is DTS curable?

DTs can be treated, not cured.

Is hospitalization necessary for treating Delirium Tremens?

Yes, hospitalization is necessary for treating delirium tremens. It is usually treated as an emergency.